{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:27:54Z","timestamp":1788488874234,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>In the management of locally advanced rectal cancer, organ preservation after total neoadjuvant therapy requires complete clinical response and close surveillance. Patients with near-complete response or tumor regrowth during watch and wait are recommended to undergo total mesorectal excision. Selective use of local resection procedures, such as endoscopic submucosal dissection, may expand organ preservation in these patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVE:<\/jats:title>\n            <jats:p>To assess the feasibility, safety, and outcomes of endoscopic submucosal dissection for patients with near-complete response or tumor regrowth after total neoadjuvant therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN:<\/jats:title>\n            <jats:p>Retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SETTINGS:<\/jats:title>\n            <jats:p>Single tertiary care center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>PATIENTS:<\/jats:title>\n            <jats:p>Patients with locally advanced rectal cancer treated with total neoadjuvant therapy between 2015 and 2024 and who underwent endoscopic submucosal dissection for near-complete response or tumor regrowth during active surveillance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>INTERVENTIONS:<\/jats:title>\n            <jats:p>Endoscopic submucosal dissection for near-complete response and tumor regrowth during watch and wait.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MAIN OUTCOME MEASURES:<\/jats:title>\n            <jats:p>Organ preservation and regrowth rates after endoscopic submucosal dissection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Twenty patients were included (40% women, mean age 59.1\u2009\u00b1\u200913.1 years). Although 10 patients underwent endoscopic submucosal dissection for near-complete response with endoluminal lesions after total neoadjuvant therapy completion, 10 underwent endoscopic submucosal dissection due to tumor regrowth during watch and wait. The median time for tumor regrowth was 12.5 months. Pathologic examination of specimens showed no invasive cancer in 14 patients (70%). Total mesorectal excision was performed in 5 patients in whom invasive adenocarcinoma was found on endoscopic submucosal dissection. The 1 remaining patient refused proctectomy. One patient with dysplasia, after an additional watch-and-wait period after endoscopic submucosal dissection, underwent total mesorectal excision to address a second regrowth. Fourteen patients, including the one who refused surgery, have been closely monitored to date, with no evidence of disease for a mean of 27.7 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LIMITATIONS:<\/jats:title>\n            <jats:p>Retrospective design and small sample size.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Selective use of endoscopic submucosal dissection can be feasible and safe for organ preservation in highly selected patients with locally advanced rectal cancer after total neoadjuvant therapy. Larger prospective trials with longer follow-up are needed to validate its value. See <jats:bold>Video Abstract.<\/jats:bold>\n                              <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>AMPLIACI\u00d3N DE LA PRESERVACI\u00d3N DE \u00d3RGANOS EN EL C\u00c1NCER RECTAL LOCALMENTE AVANZADO TRAS TERAPIA NEOADYUVANTE TOTAL CON DISECCI\u00d3N ENDOSC\u00d3PICA SUBMUCOSA<\/jats:title>\n            <jats:p>\n                                 <jats:bold>ANTECEDENTES:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>En el tratamiento del c\u00e1ncer rectal localmente avanzado, la preservaci\u00f3n del \u00f3rgano tras una terapia neoadyuvante total requiere una respuesta cl\u00ednica completa y una vigilancia estrecha. Se recomienda a los pacientes con respuesta casi completa o recidiva tumoral durante el periodo de observaci\u00f3n y espera someterse a una disecci\u00f3n mesorrectal total. El uso selectivo de procedimientos de resecci\u00f3n local, como la disecci\u00f3n endosc\u00f3pica submucosa, puede ampliar la preservaci\u00f3n del \u00f3rgano en estos pacientes.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>OBJETIVO:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Evaluar la viabilidad, la seguridad y los resultados de la disecci\u00f3n endosc\u00f3pica submucosa en pacientes con respuesta casi completa o recidiva tumoral tras una terapia neoadyuvante total.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>DISE\u00d1O:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Estudio de cohorte retrospectivo.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>ENTORNO:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Centro \u00fanico de atenci\u00f3n terciaria.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>PACIENTES:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Pacientes con c\u00e1ncer rectal localmente avanzado tratados con terapia neoadyuvante total entre 2015 y 2024, que se sometieron a disecci\u00f3n endosc\u00f3pica submucosa por respuesta casi completa o recidiva tumoral durante la vigilancia activa.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>INTERVENCIONES:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Disecci\u00f3n endosc\u00f3pica submucosa para la respuesta casi completa y el recidiva tumoral durante la vigilancia activa.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>PRINCIPALES MEDIDAS DE RESULTADO:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Tasas de preservaci\u00f3n de \u00f3rganos y recidiva tras la disecci\u00f3n endosc\u00f3pica submucosa.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>RESULTADOS:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Se incluyeron 20 pacientes (40 % mujeres, edad media 59,1\u2009\u00b1\u200913,1 a\u00f1os). Mientras que 10 pacientes se sometieron a disecci\u00f3n endosc\u00f3pica submucosa para obtener una respuesta casi completa con lesiones endoluminales tras completar la terapia neoadyuvante total, 10 se sometieron a disecci\u00f3n endosc\u00f3pica submucosa debido al recidiva tumoral durante la vigilancia activa. La mediana del tiempo de recidiva tumoral fue de 12,5 meses. El examen patol\u00f3gico de las muestras no revel\u00f3 c\u00e1ncer invasivo en 14 pacientes (70 %). Se realiz\u00f3 una disecci\u00f3n mesorrectal total en cinco pacientes debido al adenocarcinoma invasivo encontrado en la disecci\u00f3n endosc\u00f3pica submucosa. El otro paciente rechaz\u00f3 la proctectom\u00eda. Un paciente con displasia, tras un periodo adicional de espera y observaci\u00f3n despu\u00e9s de la disecci\u00f3n endosc\u00f3pica submucosa, se someti\u00f3 a una extirpaci\u00f3n mesorrectal total debido a un segundo recidiva. Catorce pacientes, incluido el que rechaz\u00f3 la cirug\u00eda, han sido objeto de un seguimiento estrecho hasta la fecha, sin evidencia de enfermedad durante una media de 27,7 meses.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>LIMITACIONES:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>Dise\u00f1o retrospectivo y tama\u00f1o reducido de la muestra.<\/jats:p>\n            <jats:p>\n                                 <jats:bold>CONCLUSI\u00d3N:<\/jats:bold>\n                              <\/jats:p>\n            <jats:p>El uso selectivo de la disecci\u00f3n endosc\u00f3pica submucosa puede ser viable y seguro para la preservaci\u00f3n de \u00f3rganos en pacientes altamente seleccionados con c\u00e1ncer rectal localmente avanzado tras terapia neoadyuvante total. Se necesitan ensayos prospectivos m\u00e1s amplios con un seguimiento m\u00e1s prolongado para validar su valor. <jats:italic toggle=\"yes\">(AI-generated translation<\/jats:italic>)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/dcr.0000000000003839","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T12:00:19Z","timestamp":1752840019000},"page":"1172-1182","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Expanding Organ Preservation in Locally Advanced Rectal Cancer After Total Neoadjuvant Therapy With Endoscopic Submucosal Dissection"],"prefix":"10.1097","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-3522","authenticated-orcid":false,"given":"Emre","family":"Gorgun","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Erozkan","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salih N.","family":"Karahan","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metincan","family":"Erkaya","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alipouriani","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Schabl","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy L.","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Kessler","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Liska","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Sommovilla","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"R1-20250915","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ejca.2023.03.021","article-title":"Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER PRODIGE 23): health-related quality of life longitudinal analysis.","volume":"186","author":"Bascoul-Mollevi","year":"2023","journal-title":"Eur J Cancer"},{"key":"R2-20250915","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.6004\/jnccn.2022.0051","article-title":"Rectal Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.","volume":"20","author":"Benson","year":"2022","journal-title":"J Natl Compr Canc Netw"},{"key":"R3-20250915","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1093\/annonc\/mdx351","article-title":"Late toxicities and clinical outcome at 5 years of the ACCORD 12\/0405-PRODIGE 02 trial comparing two neoadjuvant chemoradiotherapy regimens for intermediate-risk rectal cancer.","volume":"28","author":"Azria","year":"2017","journal-title":"Ann Oncol"},{"key":"R4-20250915","doi-asserted-by":"crossref","first-page":"e181607","DOI":"10.1001\/jamasurg.2018.1607","article-title":"Association of plane of total mesorectal excision with prognosis of rectal cancer: secondary analysis of the CAO\/ARO\/AIO-04 phase 3 randomized clinical trial.","volume":"153","author":"Kitz","year":"2018","journal-title":"JAMA Surg"},{"key":"R5-20250915","first-page":"100087","article-title":"Quality of life after sphincter preservation surgery or abdominoperineal resection for low rectal cancer (ASPIRE): a long-term prospective, multicentre, cohort study.","volume":"6","author":"Kang","year":"2020","journal-title":"Lancet Reg Health West Pac"},{"key":"R6-20250915","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/S1470-2045(21)00079-6","article-title":"Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial.","volume":"22","author":"Conroy","year":"2021","journal-title":"Lancet Oncol"},{"key":"R7-20250915","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1093\/annonc\/mdv223","article-title":"Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial\u2020.","volume":"26","author":"Fernandez-Martos","year":"2015","journal-title":"Ann Oncol"},{"key":"R8-20250915","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/DCR.0000000000002245","article-title":"Rectal cancer: clinical and molecular predictors of a complete response to total neoadjuvant therapy.","volume":"66","author":"Chapman","year":"2023","journal-title":"Dis Colon Rectum"},{"key":"R9-20250915","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1200\/JCO.22.00032","article-title":"Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy.","volume":"40","author":"Garcia-Aguilar","year":"2022","journal-title":"J Clin Oncol"},{"key":"R10-20250915","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S2468-1253(17)30074-2","article-title":"A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis.","volume":"2","author":"Dossa","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R11-20250915","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/S1470-2045(15)00467-2","article-title":"Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis.","volume":"17","author":"Renehan","year":"2016","journal-title":"Lancet Oncol"},{"key":"R12-20250915","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.ejso.2015.09.022","article-title":"Watch and wait policy after preoperative radiotherapy for rectal cancer; management of residual lesions that appear clinically benign.","volume":"42","author":"Rupinski","year":"2016","journal-title":"Eur J Surg Oncol"},{"key":"R13-20250915","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.3390\/medicina59101807","article-title":"Pattern of residual submucosal involvement after neoadjuvant therapy for rectal cancer: a rationale for the utility of endoscopic submucosal resection.","volume":"59","author":"Elazzamy","year":"2023","journal-title":"Medicina (Kaunas)"},{"key":"R14-20250915","doi-asserted-by":"crossref","first-page":"8282","DOI":"10.3748\/wjg.v20.i25.8282","article-title":"Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal tumors: a meta-analysis.","volume":"20","author":"Wang","year":"2014","journal-title":"World J Gastroenterol"},{"key":"R15-20250915","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1007\/s00384-021-03989-5","article-title":"Early salvage total mesorectal excision (sTME) after organ preservation failure in rectal cancer does not worsen postoperative outcomes compared to primary TME: systematic review and meta-analysis.","volume":"36","author":"Chaouch","year":"2021","journal-title":"Int J Colorectal Dis"},{"key":"R16-20250915","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/DCR.0000000000002407","article-title":"Completion total mesorectal excision after transanal local excision of early rectal cancer: a systematic review and meta-analysis.","volume":"65","author":"Wyatt","year":"2022","journal-title":"Dis Colon Rectum"},{"key":"R17-20250915","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S0140-6736(17)31056-5","article-title":"Organ preservation for rectal cancer (GRECCAR 2): a prospective, randomised, open-label, multicentre, phase 3 trial.","volume":"390","author":"Rullier","year":"2017","journal-title":"Lancet"},{"key":"R18-20250915","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1007\/DCR.0b013e3181f42b89","article-title":"Complete clinical response after neoadjuvant chemoradiation therapy for distal rectal cancer: characterization of clinical and endoscopic findings for standardization.","volume":"53","author":"Habr-Gama","year":"2010","journal-title":"Dis Colon Rectum"},{"key":"R19-20250915","doi-asserted-by":"crossref","first-page":"3753","DOI":"10.1200\/JCO.2011.34.9068","article-title":"Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience.","volume":"29","author":"Patel","year":"2011","journal-title":"J Clin Oncol"},{"key":"R20-20250915","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1093\/jnci\/dju248","article-title":"Comparison of tumor regression grade systems for locally advanced rectal cancer after multimodality treatment.","volume":"106","author":"Trakarnsanga","year":"2014","journal-title":"J Natl Cancer Inst"},{"key":"R21-20250915","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4103\/0019-5049.79879","article-title":"American Society of Anaesthesiologists physical status classification.","volume":"55","author":"Daabiss","year":"2011","journal-title":"Indian J Anaesth"},{"key":"R22-20250915","first-page":"93","article-title":"The eighth edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging.","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"R23-20250915","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.gie.2022.02.014","article-title":"Technical feasibility of salvage endoscopic submucosal dissection after chemoradiation for locally advanced rectal adenocarcinoma.","volume":"96","author":"Leung","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"R24-20250915","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.annonc.2022.09.160","article-title":"Short-term outcomes of chemoradiotherapy and local excision versus total mesorectal excision in T2-T3ab,N0,M0 rectal cancer: a multicentre randomised, controlled, phase III trial (the TAU-TEM study).","volume":"34","author":"Serra-Aracil","year":"2023","journal-title":"Ann Oncol"},{"key":"R25-20250915","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1111\/codi.16698","article-title":"Sense and nonsense of yT-staging on MRI after chemoradiotherapy in rectal cancer.","volume":"25","author":"El Khababi","year":"2023","journal-title":"Colorectal Dis"},{"key":"R26-20250915","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/DCR.0b013e31827541e2","article-title":"Distribution of residual cancer cells in the bowel wall after neoadjuvant chemoradiation in patients with rectal cancer.","volume":"56","author":"Duldulao","year":"2013","journal-title":"Dis Colon Rectum"},{"key":"R27-20250915","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/S1470-2045(15)00215-6","article-title":"Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial.","volume":"16","author":"Garcia-Aguilar","year":"2015","journal-title":"Lancet Oncol"},{"key":"R28-20250915","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/S2468-1253(19)30410-8","article-title":"Organ preservation with chemoradiotherapy plus local excision for rectal cancer: 5-year results of the GRECCAR 2 randomised trial.","volume":"5","author":"Rullier","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R29-20250915","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1001\/jamasurg.2018.3752","article-title":"Long-term oncological and functional outcomes of chemoradiotherapy followed by organ-sparing transanal endoscopic microsurgery for distal rectal cancer: the CARTS study.","volume":"154","author":"Stijns","year":"2019","journal-title":"JAMA Surg"},{"key":"R30-20250915","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1200\/JCO.22.00184","article-title":"Neoadjuvant chemotherapy, excision, and observation for early rectal cancer: the phase II NEO trial (CCTG CO.28) primary end point results.","volume":"41","author":"Kennecke","year":"2023","journal-title":"J Clin Oncol"},{"key":"R31-20250915","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1016\/S0140-6736(18)31078-X","article-title":"Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study.","volume":"391","author":"van der Valk","year":"2018","journal-title":"Lancet"},{"key":"R32-20250915","doi-asserted-by":"crossref","first-page":"3071","DOI":"10.3390\/cancers14133071","article-title":"Role of local excision for suspected regrowth in a watch and wait strategy for rectal cancer.","volume":"14","author":"Geubels","year":"2022","journal-title":"Cancers (Basel)"},{"key":"R33-20250915","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00464-021-08385-2","article-title":"Completion total mesorectal excision following transanal endoscopic microsurgery does not compromise outcomes in patients with rectal cancer.","volume":"36","author":"Levic Souzani","year":"2022","journal-title":"Surg Endosc"},{"key":"R34-20250915","doi-asserted-by":"crossref","first-page":"3315","DOI":"10.1007\/s00464-013-2911-x","article-title":"Previous transanal endoscopic microsurgery for rectal cancer represents a risk factor for an increased abdominoperineal resection rate.","volume":"27","author":"Morino","year":"2013","journal-title":"Surg Endosc"},{"key":"R35-20250915","doi-asserted-by":"crossref","first-page":"4490","DOI":"10.3390\/cancers15184490","article-title":"Outcome of completion surgery after endoscopic submucosal dissection in early-stage colorectal cancer patients.","volume":"15","author":"Dekkers","year":"2023","journal-title":"Cancers (Basel)"},{"key":"R36-20250915","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1007\/s00464-015-4452-y","article-title":"Transanal endoscopic resection with peritoneal entry: a word of caution.","volume":"30","author":"Molina","year":"2016","journal-title":"Surg Endosc"},{"key":"R37-20250915","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1055\/s-0032-1309403","article-title":"Endoscopic submucosal dissection in large sessile lesions of the rectosigmoid: learning curve in a European center.","volume":"44","author":"Probst","year":"2012","journal-title":"Endoscopy"}],"container-title":["Diseases of the Colon &amp; Rectum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/DCR.0000000000003839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T22:00:36Z","timestamp":1757973636000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/DCR.0000000000003839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":37,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/dcr.0000000000003839","relation":{},"ISSN":["0012-3706","1530-0358"],"issn-type":[{"value":"0012-3706","type":"print"},{"value":"1530-0358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]}}}